Exam 2 - Trichomoniasis Flashcards Preview

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Flashcards in Exam 2 - Trichomoniasis Deck (11)
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1
Q

Most common organism causing trichomoniasis

A

Trichomonas vaginalis

  • Five flagella, highly motile
2
Q

How is trichomoniasis transmitted?

A

Sexual contact

3
Q

Trichomoniasis: signs and symptoms

A

Strawberry cervix (hemorrhagic petechiae)

  • Malodorous
  • Copious thin, frothy yellow/green vaginal discharge
  • Vulvar vaginal irritation, itching
  • Excoriation
  • Vaginal or cervical discoloration (deep red/pink color)
4
Q

Trichomoniasis: diagnostic testing

A

Normally able to diagnosed based on PE and history

  • Vaginal discharge pH >4.5
  • Positive whiff test
  • Motile trichomonads noted on saline wet mount
  • Increased WBCs
5
Q

Trichomoniasis: treatment

A
  • Metronidazole 2g PO once OR metronidazole 500mg BID for 7 days
  • Tinidazole 2g PO once
6
Q

Trichomoniasis: in pregnancy

A
  • Increases risk of ROM, preterm birth, and low birth weight
  • Vertical transmission possible, but rare
    • Results in fever, respiratory or genital infection
  • Partner can be treated at any time and should be repeated when woman is treated
7
Q

Treatment of choice for trichomoniasis during pregnancy

A

Metronidazole 2g PO once

  • Transmission can still occur
  • Treated immediately or wait until 37 weeks if symptoms are not troublesome
8
Q

Trichomoniasis: treatment during breastfeeding - metronidazole

A

Metronidazole 2g PO once

  • Metabolites are transferred in breast milk
  • Avoid breastfeeding 12-24 hours after dose

Metronidazole 500mg BID for 7 days

  • Tine breastfeeding to coincide with low plasma levels
9
Q

Trichomoniasis: treatment during breastfeeding - tindamax

A

Tindamax - not recommended in breastfeeding

  • Withhold for 72 hours after dose
10
Q

Trichomoniasis: patient education

A
  • Avoid alcohol 24 hours after metronidazole (72 hours after)
  • Sexual partners should be treated whether symptomatic or not
  • Both partners should abstain from sexual contact until treatment is completed and symptoms resolved
  • Can increase risk of HIV acquisition
11
Q

Which medications should the provider consider for resistant trichomoniasis infections with ongoing symptoms?

A

Tinidazole or longer course of metronidazole

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